Radiation Oncology Unit, University Hospital of Modena, Modena, Italy.
Radiation Oncology Unit, Santa Chiara Hospital, Largo Medaglie d'oro 9, 38123, Trento, Italy.
Med Oncol. 2021 May 10;38(6):67. doi: 10.1007/s12032-021-01514-w.
The multidisciplinary management represents a crucial part of the care for cancer patients, resulting in better clinical and process outcomes, with evidence of improved survival among different cancer primary sites, including breast. According with international recommendations established by the European Society of Breast Cancer Specialists (EUSOMA), all breast-cancer patients have to be evaluated by a multidisciplinary team including radiologist, pathologist, surgeon, medical oncologist and radiation oncologist. Thus, variations in clinical practice of each specialty should be discussed and shared with all team members to guarantee a fruitful cooperation among the involved specialists. During the last decades, radiation treatment was deeply changed by the evidence-based adoption of hypofractionated radiotherapy (HFRT) as standard of treatment in patients with early-stage breast cancer undergoing conservative surgery. Moreover, mature randomized data have showed that partial breast irradiation (PBI) is an effective and safe alternative to whole breast irradiation in selected patients with low-risk early-stage breast cancer. Based on this background, we reviewed indications and critical issues of HFRT and PBI analyzing impact of their adoption from a multidisciplinary perspective.
多学科管理是癌症患者治疗的重要组成部分,可改善临床和治疗过程的结局,并在不同的癌症原发部位(包括乳腺癌)中证实可提高生存率。根据欧洲乳腺肿瘤专家学会(EUSOMA)制定的国际建议,所有乳腺癌患者必须由多学科团队评估,包括放射科医生、病理学家、外科医生、肿瘤内科医生和放射肿瘤学家。因此,应讨论各专业的临床实践差异,并与所有团队成员分享,以保证相关专家之间的富有成效的合作。在过去几十年中,放射治疗因基于证据的采用适形分割放疗(HFRT)而发生了深刻变化,HFRT 已成为接受保乳手术的早期乳腺癌患者的标准治疗方法。此外,成熟的随机数据表明,在选择的低危早期乳腺癌患者中,部分乳腺照射(PBI)是全乳腺照射的有效且安全的替代方法。在此背景下,我们从多学科角度分析了 HFRT 和 PBI 的适应证和关键问题,探讨了其应用的影响。